Reengineering Health Care

This work examines the experience of a major teaching hospital in adopting a change programme based on the principles of Business Process Reengineering (BPR). Empirical data were gathered through an intensive comparative case design, which is outlined. The outcomes of the change programme were much more nuanced than had originally been hoped, with little evidence of a wholescale organizational transformation. There was also found to be strong variability within the hospital in terms of the degree of change secured This particular empirical study adds to the more general literature on the variable impact of corporate change programmes, particularly within highly professionalized and public sector organizations. In terms of the generic change literature, we consider why it was that change outcomes were partial rather than transformational in nature. The ability of the medical profession in particular to continue to shape the change process is highlighted. It is also argued that BPR is but one example of a number of attempts to move towards more lateral forms of organizing.

Winner of the British Association of Medical Managers Medical Management Book of the Year Award 2004, Overall, I think this book could make a significant contribution to an informed consideration of the practice of change management in the NHS/public services ... I think the work stands up to the test of the times all too well., This book provides a cautionary tale about the need to be wary of dramatic organizational change efforts esposed by management consultants that may promise too much too fast., A valuable and authoritative addition to the literature ... wide-ranging and scholarly theoretical framework, and the use of the empirical findings to contribute further to theory development, are the book's great strengths ... this book will have lasting value well beyond re-engineering itself.

Terry McNulty is Senior Lecturer in Organization Behaviour at Leeds University Business School. Previously he was a senior research fellow at Warwick Business School. He has also worked in the National Health Service and for the Institute of Health Services Management. His teaching and research cover processes of organizing and change in public and private sector organizations. His research has been published in leading practitioner and scholarly journals includingOrganisation Studies, European Journal of Work and Organisational Psychology, Journal of Management Studies, Human Relations, and Corporate Governance.Ewan Ferlie is Director of Research and Professor of Public Services Management at Imperial College Management School where he has been since 1997. Prior to this he held research posts at the Personal Social Services Research Unit, University of Kent at Canterbury, and was Deputy Director of the Centre for Corporate Strategy and Change at Warwick Business School. He has also been a Non Executive Member on Warwickshire Health Authority (1993-6).